50 best practices for high-performing health system boards

A strong, nimble and stable board is integral to the viability of a health system. This governing body, which could oversee a number of hospitals, integrated health systems or philanthropic foundations, must effectively manage numerous fiduciary duties and core responsibilities.

Integrated Healthcare Strategies, a healthcare consulting firm, has developed 50 behaviors and practices that constitute an effective board. The behaviors are drawn from 10 years of client experiences and publications by The Governance Institute and the American Hospital Association's Center for Healthcare Governance, according to Integrated Healthcare Strategies.

The list is divided into nine categories: a board's three fiduciary duties and its six core responsibilities. Here are some highlights from each.

Fiduciary duties

Duty of care

The board routinely seeks the advice of independent, outside experts when evaluating its performance

The board regularly monitors organizational performance against both board-approved goals and industry benchmarks (where available) for finance, quality, customer service and business strategy

Duty of loyalty

All board members receive a detailed orientation and updates on the obligations associated with the duty of loyalty

Board members who knowingly violate conflict-of-interest and confidentiality policies are subject to removal from the board

Duty of obedience

The board takes identifiable steps, such as a mission integration assessment, to ensure the organization's mission and core values are visible throughout the enterprise

The board or a board committee routinely reviews compensation for executives, board members (if applicable) and physician leaders (medical directorships, etc.) to ensure appropriateness and alignment with statutory and regulatory guidelines

Core responsibilities

Financial oversight

All board members receive ongoing education on the financial management and health of the organization

The board demands corrective actions in response to under-performance on long-range and annual capital and financial plans

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